Clinical engineering is at a strategic developing point. Technical, economical, and cultural dynamics are at work shaping the future of clinical engineering. As the nature of clinical engineering transformed by these forces, delay or failure to adopt effective methods will result in a diminished role for clinical engineering in healthcare. This article will demonstrates in detail the challenges which the clinical engineering encounters presently and its direction of development in the future.

There are eight forms of vitamin E in human blood, including α-, β-, γ-, δ-tocopherols and α-, β-, γ-, δ-tocotrienols. As the most abundant and active form of vitamin E, α-tocopherol is widely accepted as a reliable indicator for nutritional assessment of body vitamin E status across the world. Considering that different vitamin E forms have diverse biological activities, separation and detection of different vitamin E forms in human blood facilitates the understanding of the association between vitamin E and diseases. In this review, the advances in sample-pretreatment techniques and detection techniques for vitamin E in human blood were presented. Currently, the sample-pretreatment techniques include solid-phase extraction, liquid-liquid extraction, dispersive liquid-phase microextraction, supported liquid extraction and direct protein precipitation; the detection techniques include automatic biochemical analysis, enzyme-linked immunosorbent assay, gas chromatography, liquid chromatography and ultra-high performance supercritical fluid chromatography mass spectrometry. This review summarizes the characteristics and scope of above-mentioned techniques used for detection of vitamin E in human blood, so as to provide insights into the selection of an appropriate method for inspection technicians.

BACKGROUND:A large number of studies have shown that bone marrow mesenchymal stem cels (BMSCs) with differentiation ability can be used to treat kidney injury. Epimedium has good anti-inflammatory and immune restoration ability.
OBJECTIVE:To observe the effect of epimedium with BMSC transplantation on rat’s kidney disease caused by adriamycin nephrosis.
METHODS:Fifty rats were equivalently randomized to receive no treatment in control group, tail vein injection of normal saline plus intragastric injection of normal saline in model group, tail vein injection of BMSCs plus intragastric injection of epimedium decoction in combined group, tail vein injection of BMSCs in BMSCs group, and intragastric injection of epimedium decoction in epimedium group. Rat models of adriamycin nephrosis were made in the latter four groups through tail vein injection of doxorubicin hydrochloride, while rats in the control group were only given the same volume of normal saline. Twenty-four hours after modeling, rats in the latter four groups began to be given the corresponding treatments. Epimedium decoction was given in the combined and epimedium groups at a dose of 1 mL/d, for consecutive 1 week.
RESULTS AND CONCLUSION:Compared with the model group, mitigated kidney injury and reduced urinary protein level were found in rats undergoing BMSCs and/or epimedium decoction treatment; the levels of plasma albumin and catalase were significantly increased in the combined group and epimedium group, while the levels of serum cholesterol, triglycerides and malondialdehyde decreased; the mRNA expression of transforming growth factor β1 in the kidney tissues was dramaticaly declined in the combined group and BMSC group. To conclude, the combined use of epimedium and BMSCs is superior to their use alone in the treatment of kidney disease.

Objective To investigate the effect of administration intravenously of rosiglitazone (ROSI) on severe acute pancreatitis (SAP) in rats and its mechanisms. Method Fifty-four male Wistar rats were randomly divided into sham operation group (SO group), severe acute panereatitis model group (SAP group) and rosiglita-zone pretreatment group (ROSI group),18 rats in each group.SAP model was induced by retrograde inufsion of 5% sodium taurecholate into the biliopancreatic duct. The rats in SO group and SAP group were injected with 10% DMSO (0.2 ml/100 g) by femoral vein 30 minutes piror to the operation. In ROSI group,rosiglitazone partes ae-quales(6 mg/kg) was injected instead of 10% DMSO. Rats were killed at 3, 6 and 12 h after operation. Serum amylase level and myelopemxidase activity were detected. Pancreatic tissue samples were stained with hematoxylin and eosin for histopathological evaluation. Reverse transcription-polymerase chain reaction was used for detecting the levels ofTNF-α mRNA and ICAM-1 mRNA in pancreatic tissue. Results Amylase level, myeloperexidase ac-tivity, pathologic score and the expression of TNF-α and ICAM-1 mRNA were increased significantly in SAP group at each time point than those in SO group (P<0.05). Compared with SAP group, pretreatment with rosiglitazone reduced serum amylase level and pathologic score at time point of 6 h and 12 h (P<0.05), decreased myeloper-oxidase activity at 12 h (P<0.05), downregulatied the expression of TNF-α mRNA at all time pointy, (P<0.05),ICAM-1 mRNA at 6 h and 12h(P<0.05). Conclusions Rosightazone has the effect on pancreatitis in SAP through downregulating the expression of TNF-α mRNA and ICAM-1 mRNA.

Novel cancer immunotherapy can treat tumors through regulating innate immunity and adaptive immune system. cGMP-AMP synthase (cGAS) is a key regulator of innate immune response to both exogenous and endogenous DNA. After recognizing the cytoplasmic DNA, cGAS produces the second messenger cyclic GMP-AMP (cGAMP), which subsequently combines with the adaptor STING (also known as MITA, MPYS and ERIS) to mediate innate immunity by inducing the production of type I interferons and inflammatory cytokines. Recent studies have revealed that the cGAS/STING signaling pathway can be activated by tumor-derived DNA and by-products of genomic instability and affect the incidence and development of tumors, which plays a critical role in the natural antitumor immunity across cancer types and immune checkpoint blockade therapy. In this article, current understanding of cGAS/STING signaling pathway in tumors was summarized, the pivotal role in tumor immunity and radiotherapy was highlighted, and the potential targeted or alternative therapy of this signaling pathway was reviewed.

OBJECTIVE: To analyze the experience in diagnosis, treatment and prognosis of Hashimoto's thyroiditis (HT) with coexistent thyroid papillary carcinoma(PTC). METHOD: Fifty-one cases of concomitant HT and PTC treated from February 2001 to 2008 October were retrospectively reviewed. RESULT: Twenty-eight cases of patients underwent thyroid-associated antibody test,with 5 cases TG-Ab elevated and 15 cases TPO-Ab elevated. All 51 cases were detected with thyroid solid mass on B ultrasonography test,and twenty-two cases had evidence of calcification on B ultrasound preoperatively (43.14%), five cases were suspicious of malignancy. Thyroid fine needle aspiration cytology prompted 2 cases of suspected cancer, 1 case highly suspected malignant. All patients underwent surgical treatment. In a follow-up for 8-100 months, 2 people were lost to follow-up,and the others had no recurrence or metastasis. CONCLUSION HT associated with thyroid nodules should be vigilant against malignant tendency. Preoperative combined thyroglobulin antibody (TG-Ab), antithyroid peroxidase antibody (TPO-Ab), imaging examination and fine needle aspiration cytology, contribute to the diagnosis of PTC combined HT. Surgical procedure of combined HT with PTC is the effective treatment, and the principles of its surgical treatment may be in accordance with the principle of PTC. Surgical treatment is effective with good prognosis.
Adolescent ; Adult ; Aged ; Carcinoma ; Carcinoma, Papillary ; Female ; Hashimoto Disease ; complications ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; complications ; diagnosis ; surgery ; Young Adult

Objective To preliminarily explore the feasibility of tree shrew as a new kind of animal model in research of amblyopia,to discuss the primary visual cortex plasticity mechanism of form deprivation in tree shrew,and to provide a theoretical basis for further understanding the mechanism of amblyopia formation and recovery.Methods Sixty 30-days old tree shrews were divided into five groups,12 in each group:the group A had the right eye sutured for 1 month;the group B had the right eye sutured for 2 months;the group C had the left eye sutured for 1 month and then opened and the righ eye was sutured for 1 month,in other words,the group C was performed by alternating suture;the tree shrews of control group 1(D1) were in the same age as the the group A,but fed in normal breedingenvironment;the tree shrews of control group 2(D2) were at the same age of groups B and C,but fed with a normal diet.Samples of the visual cortex were taken after the completion of modeling,and were processed to observe the histology and ultrastructure of the visual cortex,the neuron apoptosis,and the c-fos protein expression in the tree shrews of different groups.Results Damages to different degrees were found by histological and electron microscopic examination of the visual cortex in each experimental group,and they were more obvious in the group sutured for 2 months.TUNEL staining showed that there were no significant differences between the apoptosis in the experimental and control groups.The expression of c-fos mRNA and protein in the experimental groups was decreased,and it was the lowest in the group sutured for 2 months.There was a small increase in the c-fos expression after the alternate suture,and no significant difference of c-fos expression was found in the control groups.Conclusions Different degrees of deprivation amblyopia lead to different histopathological changes.There is a plasticity in the neurons affected by amblyopia.Tree shrew can be used as an ideal animal model for the studies of form deprivation amblyopia.

OBJECTIVE: To evaluate the diagnosis and surgical treatment of parathyroid carcinoma (PTC). METHOD: Clinical data of 4 PTC cases were analyzed retrospectively. Four patients all had palpable neck mass. Calcium level was (3.25 +/- 0.53) mmol/L, and PTH level was (1210.25 +/- 528.72) ng/L. Frozen section established diagnosis in only one case. Routine histopathology combined with immunohistochemistry established the diagnosis in 3 patients. Parathyroidectomy and ipsilateral subtotal thyroidectomy was performed in 3 patients; endoscopic parathyroidectomy was performed in one patient. RESULT: They were followed up for 8-60 months, Calcium level and PTH level were normal. No tumor recurrence and metastasis. CONCLUSION The diagnosis of PTC is difficult before operation. Routine blood examinations: blood calcium, blood PTH; Imaging examinations: ultrasonography, CT are helpful to diagnosis. Frozen biopsy is not satisfactory. An initial en bloc resection of tumor and adjacent structures contributes most to the prognosis.
Female ; Humans ; Male ; Middle Aged ; Parathyroid Neoplasms ; diagnosis ; surgery ; Prognosis ; Retrospective Studies ; Treatment Outcome

Objective:To compare the clinical effect of combined anterior and posterior approach and posterior median approach to treat O'Driscoll type III b fracture of ulnar coronoid process.Methods:A retrospective case control study was made on 67 patients with O'Driscoll type III b fracture of ulnar coronoid process treated in Honghui Hospital, Xi'an Jiaotong University from January 2015 to January 2019, including 35 males and 32 females, aged from 21 to 61 years [(38.0±9.4)years]. Among them, 31 patients were treated with combined anterior and posterior approach for reduction and internal fixation (combined approach group), and 36 patients with median posterior elbow approach group for reduction and internal fixation (posterior elbow approach group). The operation time, amount of intraoperative blood loss and fracture healing time were compared between groups. The visual analogue score (VAS), elbow joint range of motion and Mayo elbow performance score (MEPS) were assessed for pain and function evaluation at postoperative 1, 3, 6 months and at the last follow-up. The occurrence of complications were observed as well.Results:All patients were followed up for 12 to 28 months [(20.1±4.2)months]. There was no significant difference in operation time and VAS between the two groups ( P>0.05). The intraoperative blood loss [(133.6±20.3)ml] and fracture healing time [(12.3±1.7)months] in combined approach group were less or shorter than those in posterior elbow approach group [(144.4±22.1)ml, (13.2±2.0)months] ( P<0.05). The range of flexion and extension of elbow joint in combined approach group [(88.7±10.8)°, (111.1±13.9)°, (121.3±14.1)°, (127.1±13.3)°] was higher than that in posterior elbow approach group [(74.5±11.8)°, (97.6±12.6)°, (111.3±13.0)°, (115.2±12.7)°] at postoperative 1, 3, 6 months and at the last follow-up ( P<0.05). The MEPS in combined approach group [(31.7±8.6)points, (55.6±9.3)points, (84.6±10.5)points, (85.0±10.3)points] was higher than that in posterior elbow approach group [(27.2±8.2)points, (50.7±8.7)points, (77.4±11.2)points, (80.1±9.4)points] at postoperative 1, 3, 6 months and last follow-up ( P<0.05). The incidence of complications in combined approach group [10%(3/31)] was lower than that in posterior elbow approach group [31%(11/36)]( P<0.05). Conclusion:Compared with the simple posterior elbow median approach, the combined anterior and posterior elbow approach for treatment of O'Driscoll type IIIb fracture of ulnar coronoid process has lower intraoperative blood loss, faster fracture healing, lower incidence of complications and better elbow function.